MISTAKES I WISH TO MAKE – IS THERE FORGIVENESS FOR IT?

By Dr. Geeta Sundar

In medicine, some days are battles.

In neurosurgery, the bloody bath is worse. We have to steel ourselves and understand which ones to fight. Not each battle is worth the time or effort.

But in general, as a medical student, as an intern, as a resident, the only path to an upward graph and improvement is learning from the mistakes you learn and see others make. There is no other way around it. Mistakes have to be made. We have to know what we did wrong. We have to do them to understand that this approach, or this procedure was wrong and learn the right way of doing it. Techniques are learnt only by doing them. As a patient of mine, once told me – “You can’t learn unless I was put here for you as a patient to learn from.”

Truer words haven’t been spoken. Mistakes come in all shapes and sizes. They can span from the way you talk to a patient, the way you learn to take history, or the way you carry yourself in front of the patients, or even the manner in which you approach patient care. Some are small, silly, tiny to even make an impact. Some are large, gross, and very very gross. Some mistakes are omitted whilst others are committed. Some are ethical, some moral, others are not reflective of any value systems. Maybe they can be forgiven, whilst some are negligent and can’t be forgiven.

Where is the line you draw to define something as forgiven or not? Does it depend on the mistake you made? Does it depend on the person you committed it to? Does it depend on the manner in which the mistake you inflicted caused damage?

In surgery, everything is fair. The two pence, you ask? It’s simple. Over the years the stalwarts have operated and operate, defined procedures, lost patients, faced setbacks, but they have gotten us to where we are. Surgery is a forgiveness in itself. Every step of the surgery is a testament of the self-inflicted responsible guilt you will face when your patient does badly. There is no surgeon who doesn’t carry with himself/herself a whole box of graves as a personal baggage of the mistakes they have made over the years, which have made them better at their skills. Surgery creates, destroys and forgives as you move on. Surgery is a cleansing entity. The aura of the previous botched up surgery hangs in the halo of the lights of the operating theater as you do perform a similar case. There is no escaping from the mistakes you make. There is no escaping from your own conscience that raises its ugly head when you operate on a similar case. If you right the wrong, the pat on the back is yours alone, and you would have absolved the guilt to some extent, a barely soothing balm on a fired-up heart. If you can’t learn from it yet, then the mistake persists, blazing your raw guilt into a scorching fire…till you get better with time and right it.

I wonder then, what about mistakes you wish to make, to learn from? For personal growth? For learning? For improving your own learning curve? For understanding what you did wrong, to right your technique? For getting better at your finesse and skills? Is there a supposed ritual to act out? Is there some apology to be warranted to the patient and the family that would have suffered the mistake at your hand? Its selfish, but we all learn with time and mistakes. Practice makes perfect. Every one faces an index case that will remain in their minds forever, for being the case that taught them why they would this, over that.

For me, residency is a testimony to make all possible mistakes I can make and learn from an academic POV. I am covered from all sides with my professors and consultants who will stand up for me, bracket me and embrace my mistake as theirs and stand together as a unit to face the oncoming repercussions. I will not get this time again. Once I leave, once I am on my own, there will not be a single person who will stand in my corner, and support the mistakes I make (whatever be the cause). This is the time to push, serve, explore and tender into all possible aspects of the mistakes one can make. At a high price, I know, but such is life. A tiger will eat a deer. The deer can’t feel bad – the ecosystem has rendered it. And the tiger rights a wrong by controlling that deer population explosion. Similarly, I wish to make the mistakes in surgery where I can be taught to get better, I wish to make the possible wrong decisions only to be corrected, so I know where I need to target and focus so that I can hone out my weak points. Don’t get me wrong – I am not willfully wishing to curate a negligence on my hands, but just that I want to be allowed a space to know that I can make a mistake and know what and how to rectify it immediately. That wide berth and space accommodating would go a long way in shaping my technical skills into finesse.

(For the uninitiated – Ofc, I am not even considering mistakes that are unpardonable – like operating the wrong person, wrong limb, wrong side, or all the mistakes jotted into a penal code of offense – those are strictly not even in this conversation, they belong outside the Venn diagram I am talking about – but to prevent being misquoted later, given today’s fake news and billion specks when conversations are taken out of context – this is added here.)

But, at the end of the day, the spiritual part of me wonders, what Karma will surprise me with. Is the thought of asking forgiveness enough? Is asking forgiveness enough? Is apologizing sincerely enough? Or just the thought of wishing to mean apology enough? Maybe there is more than what meets the eye – is it more than the thoughts or the actions? Is there really a formula for Karma and the way she blesses? Or does it depend on the person who receives my words and thoughts? Or is there another 4^th dimensional entity that keeps up a sum total of all my misgivings, only to catch me unawares at a crucial period, and brandish me with all the repents of a lifetime? Is there a truth in a feeling that Karma detects? Is it measures in the emotional baggage and self-guilt I will carry forever? Or…or…or so many unanswered questions….